56,351 research outputs found
HEALTH-CARE RESOURCE UTILIZATION IN ADVANCED MELANOMA: AN ANALYSIS FROM THE MELODY OBSERVATIONAL STUDY
No full textOBJECTIVES: We conducted this study to document the health-care resource utilization associated with treatment of patients with advanced melanoma. METHODS: MELODY (Melanoma treatment patterns and outcomes among patients with unresectable stage III or stage IV disease: a retrospective longitudinal survey) is an observational study managed at 31 centers in France, Italy, and the UK. Eligible patients had attended at one of the sites with a diagnosis of unresectable stage III or IV melanoma between July 1, 2005 and June 30, 2006; data were retrieved from diagnosis (no limit date) until 2008. The primary objective was to document the first-line treatments received by patients. Secondary objectives included ascertaining health-care resource utilization related to up to three lines of treatment (anticancer and supportive care). Data were collected from patients (n = 776) using a case-report form that included information on hospitalizations, outpatient visits, hospice care, and adverse- event management (transfusions and concomitant medications including antiemetics and growth factors). Resource use data were collected from patients (n = 606) that received systemic treatment outside a clinical trial and/or supportive care. RESULTS: Twenty-nine percent (176/606) of patients required medical management for treatment-related adverse events and 32% (195/606) were hospitalized while receiving systemic treatment and/or supportive care with 25% of these having at least four hospitalizations. The median duration of hospitalization was 17 days, with 25% spending at least 29 days in hospital (may comprise multiple stays). The hospitaliza- tion rate was higher in patients receiving supportive care than those receiving anticancer treatment (86/170; 51% vs. 140/553; 25%), but median duration of hospitalization was similar (15.0 vs. 14.5 days). Results by line of anticancer therapy and supportive care will be presented. CONCLUSIONS: These results from MELODY suggest that the systemic and palliative treatments used to manage advanced melanoma are associated with considerable resource utilization, highlighting the need for more effective treatment options
Measurement of the ratio of prompt χ c to J / ψ production in pp collisions at √s = 7 TeV
Full text linkThe prompt production of charmonium χ c and J / ψ states is studied in proton-proton collisions at a centre-of-mass energy of √s = 7 TeV at the Large Hadron Collider. The χ c and J / ψ mesons are identified through their decays χ c → J / ψ γ and J / ψ → μ + μ - using 36 pb - 1 of data collected by the LHCb detector in 2010. The ratio of the prompt production cross-sections for χ c and J / ψ, σ (χ c → J / ψ γ) / σ (J / ψ), is determined as a function of the J / ψ transverse momentum in the range 2 < p T J / ψ < 15 GeV / c. The results are in excellent agreement with next-to-leading order non-relativistic expectations and show a significant discrepancy compared with the colour singlet model prediction at leading order, especially in the low p T J / ψ region
Tumor lysis syndrome, case report and review of the literature:(Letters to the editor)
No full textComment by G Masera & M Jankovic, Dept of Ped, UoMilan, Monza, Italy, in response to Lorigan et al's paper
Treatment patterns and outcomes among patients diagnosed with unresectable stage III or IV melanoma in Europe: A retrospective, longitudinal survey (MELODY study)
No full textBackground: MELanoma treatment patterns and Outcomes among patients with unresectable stage III or stage IV Disease: a retrospective longitudinal surveY (MELODY), the first multicountry, observational survey in patients with advanced melanoma, aimed to quantify the impact of existing treatment strategies by capturing information on treatment patterns and clinical outcomes. Patients and methods: Patients attending a participating site between 1st July 2005 and 30th June 2006 with ≥2 months follow-up were eligible. Data were retrieved retrospectively from advanced melanoma diagnosis until 1st May 2008. Treatment data were collected by line of therapy and response and progression-free survival data by line of systemic treatment. Overall survival (OS) was evaluated for all treated patients. Results: Among all patients screened, 776 were eligible for this analysis. Median OS from the date of advanced disease diagnosis was 16.4 months. After excluding patients diagnosed prior to 1st July 2005 to account for any bias resulting from patient selection, the 12-month survival rate and median OS from the start date of second-line treatment was 28.8% and 6.8 months, respectively. Survival was lower in patients with brain metastases, elevated lactate dehydrogenase levels and more advanced disease. Rates of complete/partial tumour response were 15% and 7% in patients treated with first- and second-line systemic therapy, respectively. Conclusions: Despite receiving first- and second-line treatment, most patients with advanced melanoma have short survival times and poor prognoses, reinforcing the need for new treatments. © 2012 Elsevier Ltd. All rights reserved
Mitomycin C in highly myopic eyes - Author reply
No full textOphthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
Convective–reactive nucleosynthesis of K, Sc, Cl and p-process isotopes in O–C shell mergers
Full text link© 2017 The Author(s). Published by Oxford University Press on behalf of the Royal Astronomical Society. We address the deficiency of odd-Z elements P, Cl, K and Sc in Galactic chemical evolution models through an investigation of the nucleosynthesis of interacting convective O and C shells in massive stars. 3D hydrodynamic simulations of O-shell convection with moderate C-ingestion rates show no dramatic deviation from spherical symmetry. We derive a spherically averaged diffusion coefficient for 1D nucleosynthesis simulations, which show that such convective-reactive ingestion events can be a production site for P, Cl, K and Sc. An entrainment rate of 10-3M⊙s-1features overproduction factors OPs≈ 7. Full O-C shell mergers in our 1D stellar evolution massive star models have overproduction factors OPm> 1 dex but for such cases 3D hydrodynamic simulations suggest deviations from spherical symmetry. γ - process species can be produced with overproduction factors of OPm> 1 dex, for example, for130, 132Ba. Using the uncertain prediction of the 15M⊙, Z = 0.02 massive star model (OPm≈ 15) as representative for merger or entrainment convective-reactive events involving O- and C-burning shells, and assume that such events occur in more than 50 per cent of all stars, our chemical evolution models reproduce the observed Galactic trends of the odd-Z elements
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Adjuvant therapy for stage II melanoma: the need for further studies
No full textImmunotherapy with checkpoint inhibitors has revolutionised the outcomes for melanoma patients. In the metastatic setting, patients treated with nivolumab and ipilimumab have an expected 5-year survival of> 50%. For patients with resected high-risk stage III disease, adjuvant pembrolizumab, nivolumab or dabrafenib and trametinib are associated with a significant improvement in both relapse-free survival (RFS) and distant metastasis-free survival (DMFS). More recently neoadjuvant immunotherapy has shown very promising outcomes in patients with clinically detectable nodal disease and is likely to become a new standard of care. For stage IIB/C disease, two pivotal adjuvant trials of pembrolizumab and nivolumab have also reported a significant improvement in both RFS and DMFS. However, the absolute benefit is low and there are concerns about the risk of severe toxicities as well as long-term morbidity from endocrine toxicity. Ongoing registration phase III trials are currently evaluating newer immunotherapy combinations and the role of BRAF/MEK-directed targeted therapy for stage II melanoma. However, our ability to personalise therapy based on molecular risk stratification has lagged behind the development of novel immune therapies. There is a critical need to evaluate the use of tissue and blood-based biomarkers, to better select patients that will recur and avoid unnecessary treatment for the majority of patients cured by surgery alone
Acute Ethanol Administration Rapidly Increases Phosphorylation of Conventional Protein Kinase C in Specific Mammalian Brain Regions in Vivo
Full text linkBackground
Protein kinase C (PKC) is a family of isoenzymes that regulate a variety of functions in the central nervous system including neurotransmitter release, ion channel activity, and cell differentiation. Growing evidence suggests that specific isoforms of PKC influence a variety of behavioral, biochemical, and physiological effects of ethanol in mammals. The purpose of this study was to determine whether acute ethanol exposure alters phosphorylation of conventional PKC isoforms at a threonine 674 (p-cPKC) site in the hydrophobic domain of the kinase, which is required for its catalytic activity.
Methods
Male rats were administered a dose range of ethanol (0, 0.5, 1, or 2 g/kg, intragastric) and brain tissue was removed 10 minutes later for evaluation of changes in p-cPKC expression using immunohistochemistry and Western blot methods.
Results
Immunohistochemical data show that the highest dose of ethanol (2 g/kg) rapidly increases p-cPKC immunoreactivity specifically in the nucleus accumbens (core and shell), lateral septum, and hippocampus (CA3 and dentate gyrus). Western blot analysis further showed that ethanol (2 g/kg) increased p-cPKC expression in the P2 membrane fraction of tissue from the nucleus accumbens and hippocampus. Although p-cPKC was expressed in numerous other brain regions, including the caudate nucleus, amygdala, and cortex, no changes were observed in response to acute ethanol. Total PKC? immunoreactivity was surveyed throughout the brain and showed no change following acute ethanol injection
Economic impact of healthcare resource utilisation patterns among patients diagnosed with advanced melanoma in the United Kingdom, Italy, and France: results from a retrospective, longitudinal survey (MELODY study).
No full textOBJECTIVE: To describe patterns of healthcare resource utilisation and associated costs for patients with advanced melanoma in the United Kingdom (UK), Italy, and France. METHODS: For patients receiving systemic treatment, or supportive care, data describing hospitalisations, hospice care, and outpatient visits were retrieved retrospectively from advanced disease diagnosis as part of a multicountry observational study. Costs were estimated by multiplying utilisation level by unit cost. In an exploratory analysis, costs were compared between individuals who died within one year of initiating first-line treatment (short-term survivors) and those with ≥ 1 year follow-up (long-term survivors). RESULTS: Hospitalisation costs were highest in France (€6262 per-person compared with €3225 in the UK and €2486 in Italy), reflecting higher rates of hospitalisation. In contrast, outpatient costs were highest in the UK (€782 per-person, compared with €115 in France and €72 in Italy), reflecting the highest rate and frequency of outpatient visits and the highest cost per visit. Hospitalisation rates were consistently higher during supportive care compared with systemic therapy. Roughly one-third of patients entered clinical trials and were not included in the analysis. In exploratory analysis, total costs were generally higher for long-term survivors, but monthly per-patient costs were generally lower for long-term survivors, consistent with a hypothesis that resource utilisation and costs do not necessarily increase proportionally with extended survival. CONCLUSION: Total costs associated with resource utilisation for advanced melanoma patients varied across countries. Overall cost differences were due to differences in frequency and intensity of utilisation patterns and variation in unit costs of health resources
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